British Journal of Radiology最新文献

{"title":"Non-contrast abbreviated MRI for the detection of hepatocellular carcinoma in patients with Liver Imaging Reporting and Data System LR-3 and LR-4 observations in MRI.","authors":"Soe Thiha Maung, Natthaporn Tanpowpong, Minchanat Satja, Sombat Treeprasertsuk, Roongruedee Chaiteerakij","doi":"10.1093/bjr/tqae140","DOIUrl":"10.1093/bjr/tqae140","url":null,"abstract":"<p><strong>Background and aims: </strong>With ultrasound sensitivity limited in hepatocellular carcinoma (HCC) surveillance and few prospective studies on non-contrast abbreviated MRI (NC-AMRI), this study aimed to assess its diagnostic performance in detecting HCC.</p><p><strong>Methods: </strong>This prospective study involved cirrhotic patients with contrast-enhanced MRI (CE-MRI) Liver Imaging Reporting and Data System (LI-RADS) LR-3 and LR-4 observations detected during HCC surveillance. Patients underwent average 3 complete CE-MRI rounds at 3-6 months interval, with approximately 12-month follow-up. NC-AMRI included diffusion-weighted (DWI), T2-weighted imaging (T2WI), and T1-weighted imaging (T1WI). NC-AMRI protocol images were analysed for diagnostic performance, with subgroup analyses. CE-MRI and NC-AMRI images were independently reviewed by 2 experienced radiologists, with inter-reader agreement assessed with Kappa coefficient. The reference standard was the American Association for the Study of Liver Diseases-defined presence of arterial hypervascularity and washout during the portal-venous or delayed phases on CE-MRI.</p><p><strong>Results: </strong>In 166 CE-MRI follow-ups of 63 patients (median age: 63 years; 60.3% male, 39.7% female), 12 patients developed HCC, with average size of 19.6 mm. The NC-AMRI (DWI + T2WI + T1WI) showed 91.7% sensitivity (95%CI, 61.5-99.8) and 91.6% specificity (95%CI, 86.0-95.4), area under receiver operating characteristic 0.92 (95%CI, 0.83-1.00). Across different Body Mass Index categories, lesion size, Child-Turcotte-Pugh classes, Albumin-Bilirubin (ALBI) grades, and Model for End-Stage Liver Disease classes, sensitivity remained consistent. However, specificity differed significantly between ALBI grade 1 and 2 (86.7% vs. 98.4%, P = .010), and between viral and non-viral cirrhosis (93.8% vs. 80.8%, P = .010).</p><p><strong>Conclusions: </strong>NC-AMRI proved clinically feasible, and exhibits high diagnostic performance in HCC detection.</p><p><strong>Advances in knowledge: </strong>This study highlights efficacy of NC-AMRI in detecting HCC among cirrhotic patients with LR-3 and LR-4 observations, representing significant progress in HCC surveillance.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1671-1682"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A dual-center study: can ultrasound radiomics differentiate type I and type II epithelial ovarian cancer patients with normal CA125 levels?","authors":"Lixuan Chen, Chenyang Jin, Bo Chen, Asta Debora, Weizeng Su, Qingwen Zhou, Shuai Zhou, Jinyan Bian, Yunjun Yang, Li Lan","doi":"10.1093/bjr/tqae144","DOIUrl":"10.1093/bjr/tqae144","url":null,"abstract":"<p><strong>Objective: </strong>CA125 is recommended by many countries as the primary screening test for ovarian cancer. But there are patients with ovarian cancer having normal CA125. We hope to identify the types of EOC with normal CA125 levels better by building a refined model based on the ultrasound radiomics, thus providing precise medical treatment for patients.</p><p><strong>Methods: </strong>We included 58 patients with EOC with normal CA125 from 2 centres, who were confirmed by preoperative ultrasound and pathology. We extracted 1130 radiomics features based on the tumour's region of interest from the most typical ultrasound image of each patient. We selected radiomics and clinical features by LASSO and logistic regression to construct Rad-score and clinical models, respectively. Receiver operating characteristic curves judged their test efficacy. On the basis of the combined model, we developed a nomogram.</p><p><strong>Results: </strong>Area under the curves (AUCs) of 0.93 and 0.83 were achieved in both the training and test groups for the combined model. There were similar AUCs between the Rad-score and clinical models of 0.82 and 0.80, respectively. By analysing the calibration curves, it was determined that the nomogram matched actual observations in the training cohort.</p><p><strong>Conclusion: </strong>Ultrasound radiomics can differentiate type I and type II EOC with normal CA125 levels.</p><p><strong>Advances in knowledge: </strong>This study is the first to focus on EOC cases with normal level of CA125. The subset of patients constituting 20% of the disease population may require more refined radiomics models.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1706-1712"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance and results of cryoablation for the treatment of early breast cancer in non-surgical patients.","authors":"Lucía L Graña-López, Laura L Abelairas-López, Ignacio I Fernández-Sobrado, Sabela S Verea-Varela, Ángeles A Villares-Armas","doi":"10.1093/bjr/tqae131","DOIUrl":"10.1093/bjr/tqae131","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate acceptance of percutaneous cryoablation (PCA) treatment by patients with early breast cancer (BC) who choose not to have surgery and present our experience in the use of PCA for the local control of BC in this group of patients.</p><p><strong>Methods: </strong>All biopsy-proven early BC diagnosed in our institution as non-surgical patients between January 2020 and December 2023 were retrospectively reviewed. We recorded if PCA was offered and if it was accepted by the patient. PCA was performed under ultrasound (US) guidance, using a liquid nitrogen-based system. Mammography and US or contrast-enhanced mammography follow-up was scheduled every 6 months for 5 years. Patient's tolerance to the procedure, adverse effects, and results regarding local control of the disease were assessed.</p><p><strong>Results: </strong>A total of 66 early BC were diagnosed in 63 patients who decided not to have surgery. Median age was 88 years (range 60-99 years). Forty-three (95.6%) of the 45 patients offered PCA accepted. Thirty-nine malignant tumours (median size 24 mm) underwent PCA. All cases were previously reviewed in a multidisciplinary tumour board. Complete tumour necrosis was achieved in 81.3% of the cases followed for ≥ 6 months. After a median follow-up of 16 months, the complete ablation rate in Luminal BC ≤ 25 mm was 100%. No major complications were seen.</p><p><strong>Conclusions: </strong>Non-surgical patients with early BC accepted PCA when the treatment was offered. PCA is safe, effective, and well-tolerated outpatient procedure. The study outcomes suggest that PCA could be an alternative to surgery for the management of BC in this group of patients.</p><p><strong>Advances in knowledge: </strong>Patients with early BC who choose not to have surgery accept PCA. This percutaneous approach probably allows local control of early BC, mainly in ≤25 mm Luminal tumours.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1713-1723"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of contrast-enhanced mammogram as an adjunct to tomosynthesis in evaluation of circumscribed breast lesions.","authors":"Dharmalingam Porkodi, Jagannathan Devimeenal","doi":"10.1093/bjr/tqae130","DOIUrl":"10.1093/bjr/tqae130","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the role of contrast-enhanced mammogram (CEM) in the characterization of circumscribed lesions detected in digital breast tomosynthesis (DBT) and correlated with histopathology.</p><p><strong>Methods: </strong>A retrospective study was done on 205 circumscribed breast masses detected with DBT and for whom CEM was done before core biopsy/excision biopsy. Morphology of lesion enhancement was noted at a 2-min CEM image and depending on the enhancement pattern, they were classified as benign, malignant, and indeterminate. Indeterminate lesions were further characterized by contrast kinetics at 8 min and divided into benign and malignant lesions. The results were correlated with histopathology reports.</p><p><strong>Results: </strong>Among the 205 lesions, 158 were benign and 47 were malignant by histopathology. All 47 malignant cases were diagnosed as malignant (sensitivity-100%) and 150 out of 158 benign lesions were diagnosed as benign by CEM (specificity-95%). Eight benign lesions were reported as malignant (false positive) by CEM. Positive predictive value was 85.4% (47/55); negative predictive value (NPV) was 100% (150/150); accuracy was 96% (197/205).</p><p><strong>Conclusions: </strong>The high sensitivity of CEM in our study suggests that CEM helps in the early diagnosis of benign-looking circumscribed breast malignancies. The high NPV of CEM helps to avoid unnecessary biopsies and interventions in benign lesions.</p><p><strong>Advances in knowledge: </strong>This study describes the contrast enhancement pattern of benign and malignant circumscribed breast lesions and thereby helps in the diagnosis of malignancy at an early stage. CEM is a promising adjunct tool since it offers functional imaging as a supplement to anatomical imaging by DBT.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1696-1705"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coccygeal tumours unveiled: a retrospective cohort analysis from a tertiary referral centre.","authors":"Sai Niharika Gavvala, Ahmed Saad, Kapil Shirodkar, Sisith Ariyaratne, Neha Nischal, Vineet Kurisunkal, Karthikeyan P Iyengar, Rajesh Botchu","doi":"10.1093/bjr/tqae148","DOIUrl":"10.1093/bjr/tqae148","url":null,"abstract":"<p><strong>Background: </strong>Isolated tumours affecting the coccyx are infrequent, with only a handful of documented cases in the literature. Herein, we highlight the most extensive consecutive case series involving various isolated coccyx tumours with varied clinical presentations and imaging features.</p><p><strong>Methods: </strong>A retrospective search of our tertiary Orthopaedic oncology institute's oncology and Radiology database [Radiology Information System, Picture Archiving and Communication System, and Computerised Radiology Information System] for the keyword \"Coccyx\" and \"Tumour\" was performed over 15 years (between December 2007 and August 2022). Data collected was correlated with local histopathology and laboratory records. Patient demographics, clinical characteristics, and complementary imaging findings were recorded for analysis.</p><p><strong>Results: </strong>One hundred and three lesions originating in the coccyx with a mean age of 62 years (range 25-90 years) were identified. There was a male preponderance with 59 male and 44 female patients (1.3:1.0). The most typical tumour noted was chordoma. Other lesions included a dermoid cyst, a myxopapillary ependymoma, a notochordal remnant, an osteochondroma, an Ewing sarcoma, and a teratoma.</p><p><strong>Conclusion: </strong>Our analysis suggests that most of the tumours involving coccyx are chordomas with a few rarely encountered benign and malignant tumours. Radiological imaging plays a vital role in characterising isolated tumours affecting the coccyx and guiding appropriate patient management.</p><p><strong>Advances in knowledge: </strong>This is the largest reported series of coccygeal tumours. Chordoma is the commonest coccygeal tumour. Patients with unexplained coccydynia should undergo detailed investigations, preferably with cross-sectional imaging.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1636-1644"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative imaging of colorectal liver metastases: what the radiologist and the multidisciplinary team need to know.","authors":"Philip J Dempsey, Cormac Farrelly, Carmel G Cronin, Helen M Fenlon","doi":"10.1093/bjr/tqae133","DOIUrl":"10.1093/bjr/tqae133","url":null,"abstract":"<p><p>The management of patients with colorectal liver metastases (CRLM) has transformed over the past 2 decades. Advances in surgical techniques, systemic therapies, and local treatments have resulted in a paradigm shift. Disease that would once have been considered terminal is now frequently treated aggressively with both a disease-free and overall survival benefit. In line with the expanding range of treatment options, there has been an increase in the volume and complexity of imaging required in the management of these patients to ensure optimal patient selection and outcome. The radiologist plays a pivotal role in interpreting these studies, conveying the relevant information and informing the discussion at multidisciplinary team meetings. The purpose of this review is to provide an update for radiologists on the current surgical management of patients with CRLM highlighting specific imaging information that is required by the multidisciplinary team when assessing resectability and/or the need for additional liver-directed therapies.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1602-1618"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of percutaneous antegrade double-J ureteral stent placement: first-hand vs. nephrostomy route approaches.","authors":"Muhammet Arslan, Halil S Aslan, Kadir H Alver, Mahmut Demirci","doi":"10.1093/bjr/tqae143","DOIUrl":"10.1093/bjr/tqae143","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to conduct a comparative analysis of procedural efficacy, safety, and patient outcomes between 2 distinct approaches for percutaneous antegrade double-J ureteral stent (DJS) insertion: the first-hand approach and via a nephrostomy route.</p><p><strong>Methods: </strong>Electronic records of patients undergoing percutaneous antegrade ureteral DJS placement from January 2016 to 2023 were reviewed. Patients were categorized into 2 groups based on stent placement technique: the first-hand group, involving a single-stage approach without prior percutaneous nephrostomy catheter insertion, and the nephrostomy group, where stent placement occurred through a percutaneous nephrostomy tube. Clinical data, including patient demographics, primary diagnoses, procedural details, complication rates, stent placement success, and post-procedural outcomes, were collected and analysed.</p><p><strong>Results: </strong>Both approaches demonstrated high technical success rates (93.1%). However, the nephrostomy route group exhibited a comparatively higher fluoroscopy exposure rate (8.2 min) than the first-hand group (6.8 min). Moreover, the complication risk increased by 3.08 times in patients treated with the nephrostomy method (P = .047). Notably, in cases of urinary malignancies, the preference was for placing DJS via nephrostomy.</p><p><strong>Conclusion: </strong>The first-hand approach should be prioritized as the initial choice in suitable cases owing to its reduced fluoroscopy time, lower complication rate, and the single-stage nature of the procedure.</p><p><strong>Advances in knowledge: </strong>With the exception of cases necessitating urgent drainage, such as post-renal acute renal failure and urosepsis, the first-hand method is the primary approach for inserting DJS. This is primarily due to the significantly shorter radiation time and the single-stage nature of the procedure.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1683-1689"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When advanced MRI is not about naming musculoskeletal lesions.","authors":"Teodoro Martín-Noguerol, Oscar L Casado-Verdugo, Joan C Vilanova, Antonio Luna","doi":"10.1093/bjr/tqae139","DOIUrl":"10.1093/bjr/tqae139","url":null,"abstract":"<p><p>Nowadays, the use of advanced MRI sequences such as diffusion-weighted imaging or perfusion-weighted imaging in the field of musculoskeletal radiology remains limited compared to other anatomical regions and subspecialties. Several reasons underpin this, primarily technical challenges, and a longstanding reliance on conventional and morphological evaluations of soft tissue and bone lesions. Experienced radiologists often assert that these advanced sequences do not offer added diagnostic value, claiming that a morphological approach suffices. However, in our opinion, the role of these advanced MRI sequences extends beyond merely naming an MSK lesion. In this commentary, we elucidate how these sequences can aid radiologists in various scenarios, from determining patient prognosis and tracking treatment progress to enhancing clinical-radiological correlations or guiding less experienced radiologists in evaluating soft tissues or bone tumours.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1619-1621"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclin-dependent kinase 4/6 inhibitors combined with stereotactic ablative radiotherapy in oligometastatic HR-positive/HER2-negative breast cancer patients.","authors":"Marcin Kubeczko, Dorota Gabryś, Aleksandra Krzywon, Michał Jarząb","doi":"10.1093/bjr/tqae138","DOIUrl":"10.1093/bjr/tqae138","url":null,"abstract":"<p><strong>Objectives: </strong>Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) have significantly improved the survival of patients with hormone receptor-positive HER2-negative advanced breast cancer (ABC). Although stereotactic ablative radiotherapy (SABR) is used more often in routine clinical practice, data on the safety and efficacy of combining SABR with CDK4/6i are lacking. Herein, we present the results of SABR combined with CDK4/6i in ABC.</p><p><strong>Methods: </strong>Patients with ABC who received CDK4/6i and SABR between 2018 and 2023 were analysed.</p><p><strong>Results: </strong>Among 384 patients treated with CDK4/6i, 34 patients received 44 courses of SABR. Two-year progression-free survival (PFS) was 63.6% (95% CI, 45.8-88.3), and the median PFS was 32 months. Three-year overall survival (OS) was 88.9% (95% CI, 77.7-100). Two-year local control (LC) was 92.7% (95% CI, 83.4-100). Median OS and LC were not reached. The subgroup analysis showed the difference in survival between oligometastatic patients (OMD) and non-OMD subgroup. Two-year PFS was 69.2% (95% CI, 44.5-100) in OMD compared with 57.4% (95% CI, 36-91.7) in the non-OMD (P = .042). Three-year OS was 90% (95% CI, 73.2-100) in OMD compared with 86.2% (95% CI, 70-100) in the non-OMD (P = .67). Median PFS and OS in the non-OMD were 26 and 56 months, respectively, and were not reached in OMD. Fifteen patients required CDK4/6i dose reduction, and 2 discontinued treatment due to toxicity. No difference in high-grade toxicity was observed between the sequential and concurrent SABR.</p><p><strong>Conclusion: </strong>The addition of SABR to CDK4/6i seems to be safe and effective, especially in patients with oligometastatic disease.</p><p><strong>Advances in knowledge: </strong>In advanced breast cancer patients treated with CDK4/6i, SABR provides a high local control and may provide additional benefit in an oligometastatic setting.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1627-1635"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion tensor imaging in Behcet's disease with and without neurological involvement patients: evaluation of microstructural white matter abnormality with a tract-based spatial statistical analysis.","authors":"Kerim Aslan, Barış Genç, Necdet Bolat, Lutfi Incesu","doi":"10.1093/bjr/tqae150","DOIUrl":"10.1093/bjr/tqae150","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the microstructural abnormalities in white matter (WM) among Behcet's disease (BD) patients, both with and without neurological involvement, utilising tract-based spatial statistics (TBSS) to elucidate the underlying causes of WM microstructural changes.</p><p><strong>Methods: </strong>This prospective study comprised 43 BD patients without neurological involvement, 15 neuro-Behcet's disease (NBD) patients with normal conventional MRI, and 54 healthy controls matched for age and sex. TBSS was applied in this diffusion tensor imaging study to conduct a whole-brain voxel-wise analysis of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of WM.</p><p><strong>Results: </strong>Compared to the control group, BD patients exhibited decreased FA and increased MD and RD in nearly all WM tracts, along with increased AD in the left corticospinal tract (CST), left inferior longitudinal fasciculus (ILF), and left superior longitudinal fasciculus (SLF). NBD patients also showed a widespread decrease in FA and increased MD and RD, similar to BD patients without neurological involvement. Additionally, NBD patients had increased AD in the left CST, left ILF, left SLF, left inferior fronto-occipital fasciculus (IFOF), and right CST. Compared to BD patients without neurological involvement, NBD patients exhibited a greater reduction in FA and an increase in MD and RD in WM tracts, with no significant differences in AD.</p><p><strong>Conclusion: </strong>These results suggest that the main mechanism of microstructural changes in the WM of BD patients may be related to impaired fibre integrity, demyelination, and decreased myelin sheath integrity.</p><p><strong>Advances in knowledge: </strong>This study demonstrated BD patients without neurological involvement and NBD patients a decrease in FA and an increase in MD and RD were observed in larger areas of major WM tracts, while an increase in AD values was observed in fewer tracts. Our findings may be useful in understanding the pathophysiology underlying subclinical parenchymal involvement and neurological dysfunction in BD patients and the management of BD patients.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"1645-1652"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}